Vital Connections in Long-Term Care Spiritual Resources for Staff and Residents By Julie Barton, M.A., Marita Grudzen, M.H.S., and Ron Zielske, M.Div.

Excerpted from the Introduction for Vital Connections in Long-Term Care: Spiritual Resources for Staff and Residents by Julie Barton, Marita Grudzen, and Ron Zielske.

Copyright © 2003 by Health Professions Press, Inc. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

Introduction

This book is intended to assist staff in understanding the spiritual nature of all human beings, especially in caring for older adults, and to assist staff in exploring the spiritual dimensions of their work, thus enhancing the total well-being of nursing facility residents. Although a wholistic (holistic) approach to care has become popular since the late 1990s, the spiritual dimensions of life are not always included. The whole person is not only mind and body, but mind, body, and spirit. Some would argue that a person’s spirituality is the very foundation of the physical, mental, and emotional components of the self.

Everyone is spiritual; however, not everyone has a religious belief. Spirituality can include a specific religious practice of a specific group or denomination (e.g., Presbyterian) in that group, but spirituality includes all that creates meaning in one’s life.

Consider the following story: A speaker once began a seminar by holding up a $20 bill and asking who wanted it. Every hand in the audience went up. Next, he took the $20 bill and crumpled it in his hand and then asked who wanted it. Again, everyone’s hand went up. Then, he took the $20 bill and threw it on the floor and stepped on it and asked who wanted it. Of course, everyone’s hand went up. The $20 bill does not lose its value despite its condition. Likewise, human beings, though dropped, crumpled, and stepped on during the course of their lives, never lose value. Their worth is determined by who they are more than by what they have done. This intrinsic value and worth is a large part of how we define spirituality.

Kathleen R. Fischer, author of Winter Grace: Spirituality and Aging (1998), said that spirituality is how we live out the relationship we have with a higher being or what we claim to be meaningful in life. Rabbi Samuel Seicol (1994), Director of Religious Services at the Hebrew Rehabilitation Center for Aged in Boston, offered this definition: “Spirituality is the internal sense of wellness, the sense of commonality among all people. In religious terms, it is that aspect of a person that is created in God’s image. Spirituality is the process of connecting to our sense of meaning, value, and purpose to create a sense of identity.” The National Interfaith Coalition on Aging (1975) defined spiritual well-being as the “affirmation of life, . . . a relationship with God, self, community, and environment . . . that nurtures and celebrates wholeness.”

The value of lifelong learning is included in the concept of spirituality and holds true for residents, staff, and families. Life is about growth, and all learning is mutual. We are sometimes the teachers, sometimes the students, and sometimes both at once! Good teachers often say, “I learn more from my students than I could ever teach them.” This mission can be extended to our care facilities: We learn from each other, simply through the art of listening, by learning to express an emotion through poetry or painting, or by coming to know the history of a person or place. All of this is a vital part of spiritual growth and well-being, a “vital connection” because it honors both teacher and student. This concept is central to the chapters in this book.

Sometimes, we have difficulty realizing that residents in a long-term care facility can and should go on learning. Perhaps this true story will illustrate our point: In a California facility, a female resident who was considered particularly difficult was invited to participate in a poetry writing class in which each resident contributed a line or two to an original group poem. Not only did this woman, who was severely impaired, rise to the challenge, but she shared what she had written on a videotape that the teacher made. When the aide who was assigned to this resident happened to walk through the room in which the tape was playing, she stopped in her tracks and her mouth literally fell open. She had previously not been able to see past the resident’s difficult behavior to see her possibilities. Now, she, too, was able to participate in a learning process: She learned to look at a fellow human being in a completely new way, and the resident learned to express herself in a beautiful and constructive manner. The staff and residents no longer thought of the resident as “the difficult patient in Bed A!” In addition, the teacher learned never to write off anyone as unsuited to a particular learning experience.

Our hope is that long-term care facilities will avail themselves of community teachers, volunteers, and professionals. Adult education and community college programs are usually offered at no cost to many long-term care facilities. Art docents and music teachers may also be willing to share their expertise, and high school or college interns may be of great intergenerational value. In addition, many residents may have experiences that they are willing to share with others. The idea of lifelong learning invites us to participate in the creation of something beautiful and useful, which is truly a spiritual necessity for us all.

This book presents an opportunity to explore and address spiritual wellbeing in relationship to the physical, mental, and emotional needs of individuals receiving long-term care services; their families; and the staff. The spiritual well-being of all three is the goal of this book. The spirituality and ethical and multicultural issues of older adults with Alzheimer’s disease and dementia are also addressed.

This very practical book is for caregivers who perform the hands-on work of caring for elders. The chapters in this book contain Objectives, Discussion questions, Exercises, illustrative stories, Action Steps (for implementing new knowledge and skills), Recommended Reading, and Resources. The Discussion questions and Exercises bring to light the sacredness of spiritual growth and suggest new ways of developing meaning and value in life. As staff members go through the Discussion questions and Exercises, we would like them to envision that they are caring for their own parents. The chapters illustrate the importance of incorporating spiritual concerns into models of wholistic care for elders. The contents of these chapters will also assist the director of staff development in meeting the regulatory requirements for the education of nursing assistants about the issues involving spirituality.

You are undoubtedly already familiar with and practicing some of the suggestions in this book. We hope that these chapters will increase your knowledge and enhance your practices. Significant spiritual interconnections and growth occur each day among residents, staff, and families, and as such, long-term care facilities become sacred spaces.

REFERENCES

Fischer, K.R. (1998). Winter grace: Spirituality and aging. Nashville: Upper Room Books.

National Interfaith Coalition on Aging. (1975). Definition of spiritual well-being. Retrieved January 31, 2003, from http://www.ncoa.org (click on “Constituent Units,” then click on “NICA,” then click on “News & Resources”).

Seicol, Rabbi S. (1996). Spirituality, health, and aging: The health of the human spirit. Paper presented at the American Society on Aging Annual Conference, Anaheim, California.